21 June, 2024


The Dilemma ‘To Treat Or Not To Treat’

By Harendra de Silva

Vidyajyothi Prof. Harendra de Silva

One doctor’s refusal to treat a politician has stirred a hornets’ nest of opposing opinions. Has he done the right thing or not?

On one hand, a majority professionals are supporting the change in governance with the youth leading the way. They are desperate since the government party politicians and other affiliated parties are preventing the anticipated change coming from their public outcry with irrational arguments including alleged bribery in US$! One of the salient features is the sustained non-violence principle advocated by them; although the government is not budging in any tangible way. The government is also guilty of provoking them with physical attacks. The Youth are well aware of this strategy and would not fall for it. The danger is, when people who are suffering without any guidance would at sometime turn violent which the government would use to justify violence in a bigger way to suppress it.

Boycott is one of the most effective non-violent weapons that could be used, especially when the government is not moving. The elite and professionals have an effective clout to jitter the government, especially in using non-violence! I don’t have to repeat Gandhi’s strategies. When, how and by whom matters. I believe that professionals are strategists but a few would obstruct it especially when they have a conflict of interest. Personal favours, rewards and appointment to positions of power are some instances, which may be hidden in a shroud of irregularity on whether someone claims to be viyatha or not. The professionals should start strategizing using experienced think tanks. Knee Jerk reactions are often Misconstrued and used to the success of opponents. Instead of emotional spontaneous reactions, it is well advised to draw policies by the different professional groups reviewing it from the feedback.

Boycott of patients by medical personnel could cause an uprising by some professionals as well as lay public with genuine concerns. We should not fall prey to others with conflict of interests who could capitalise on it. In this situation, professionals who have been ‘bribed’ with positions may make their own interpretations to curry favour with government for future positions. It is also said that some medical personnel who are competing with the particular doctor in private practice which may be catalysts with possible trade unions to ignite the issue. With this particular doctor’s reaction many were elated and called for others to follow. It is the emotional atmosphere reacting to a stubborn stand by government which led to the incident. However, while pursuing the immense pressure on government, we cannot afford to be naked even for a moment! It is crucial to realise that: on a positive note, although not encouraging it, this has given jitters to the rulers who should be made to succumb to pressure, but it may raise questions in ethics.

Let me suggest a few strategies:

Most of these strategies have been suggested ad hoc. It should be streamlined and properly strategized, most of which will be more effective than what has happened.

1. Doctors have to be concerned of the ethical code of conduct. It is better to go by the book on ethics and decided by a group of senior professionals including lawyers to prevent possible litigation. These people should publish the details for doctors to follow. On the same note Health professional staff going on strike raises the question whether it affects politicians or the poor public. Wouldn’t it be double jeopardy to the public? We should leave individual doctors to follow this advice without accusing doctors for not boycotting them. They may not be given priority and should be treated like a normal patient preferably requesting them to go to government hospitals. I leave it to the committee to draw guidelines.

2. Hooting at politicians and denigrating their superior public stature to affect their security as a politician or person in society is critical. It should never cause physical harm but emotional instability. Belittling politicians started at a cricket match a few months ago. The same politician involved in the treatment controversy was hooted at a restaurant not so long ago. Today’s hooting and denigration of the most popular politician ever in Sri Lanka, in Anuradhapura would have been like an earthquake crumbing under his feet at one of the most sacred places in Sri Lanka. None of the strands of multi coloured mythological threads on his wrists, talismans he wore or held in his hand nor the vows made to all sorts of gods were able to avert the evil spell he encountered. Something that rings in my mind is “All the King’s horses and all the king’s men. Couldn’t put Humpty together again”. I hope that the mind of this charismatic, crafty, supposedly invincible, stubborn and strong man was shattered today by the people. More and more politicians should be jeered but without bodily harm. We don’t want a repetition of what happened to Gaddafi!

3. Opposition politicians should get a cue from what is happening to a former prime minister.

4. Do not invite any Politician as a chief guest or as an attesting witness at weddings. This concept should be widely disseminated.

5. Boycott all such receptions with protests to deter such invitations.

6. Organise, determine and arrange protests during visits to their respective constituencies or their homes. Physical attacks to property or persons; is condemned.

7. Contractors, engineers and workers should stop or go slow at private sites of these politicians. Engineers should develop their own protocols.

8. Lawyers in General have done yeomen service to the struggle except for a few oligarchs who may appear for the culprits. Lawyers should have a similar protocol as doctors within ethics to refuse appearing for new cases. Lawyers should also file new cases against them at least in the form of public interest litigations. It is interesting that some opposition members drop file by file of alleged corruption! Aren’t they guilty of not filing cases against those allegations? Accountability is for all including the opposition, you and me.

9. Similarly, all other professions and workers should organize their own strategies.

10. None of these actions should harm life or physical injury at all to anyone. (Mental disease and suicide may be exempted)

11. It also should not lead to suffering or death of the common man.

12. Of course, many other strategies may be properly planned and executed. Brainstorm a trustworthy think tank.

There is one important aspect. This ‘Aragalaya’ – ‘අරගලය’ (struggle) should not stop but sustained to gather momentum till the downfall of the corrupt and evil regime.

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Latest comments

  • 17

    The “Aragalaya” is well deserved. One may say that the country was severely mismanaged while the politicos aggrandized themselves with the loot while others say this was engineered on purpose by one family member to oust the others for his benefit. I go to the extent of saying the necessity to charge individuals for treason if this was done on purpose and/or willful neglect. The public suffering is enormous. However, that does not give license to a registered practitioner to refuse treatment and make a public statement on it. That too is an unpardonable misconduct. If I were in his position, as my conscience is pricking (the very sight of the animal in human form) and thereby making me incapable of treating I would call another colleague of mine as to whether he was willing to treat the patient and then refer to the colleague.

    • 4

      This makes better sense.

      • 9


        Where are you?
        One of Mahinda’s goon was caught and tied to a lamp post. Another fat one was drunk when people caught him in the act, stripped of his clothes, … another one was bleeding who said he was paid Rs 2000, …… another video produced a list of buses higher to ferry Gundas from all over the island.

        Were you one of them?
        Its not worth fighting for Rs 2,000 and a bottle.
        Is it worth fighting for Gota/Mahinda?
        According to Mirror son took a flight this morning.

        Get the next boat to Thamil Nadu where you will be safe, tell them Sambandan sent you there. Stalin has promised to look after you.
        Tell them you are a Sinhalese but never say you are Sinhala/Buddhist. If you say you are a Sinhala/Buddhist you will be DEPORTED back to Sri Lanka.

    • 7

      Dr. De Silva, don’t you think that the protestors who are organized anonymously via social media platforms are also controlled by external actors who control the internet? Are we all being let by the nose to disrupt and further destroy the suffering Lankan Economy and send it to the arms of IMF and Washington?
      If these same protestors protested during the past 2 years of Covid LOCKDOWNs the destroyed the economy which were promoted by GMOA, SLMA and Mr. PCR Test Ravi Kumudesh and on Social media messages, the country would not be in the current mess?
      Covid-19 fear was also spread via corporate conrolled social media channel to digitalize and inject people!

      • 10

        Of course the US citizens Basil, Goat and MR must go! But we need to stop following the gamed narratives and Pied Pipers on Social Media and demand return of the Yugadanavi Power plant sold to a US company and also accountability from Doctors who promoted the Covid-19 injection project and Lockdowns in Sri Lanka. The Health sector consume 40 percent of the economy last year and its medicine purchases should be INVESTIGATED??!!!
        Who is leading the Protestors and trade Unions to further destroy the Lankan economy NOW? Facebook was used to spread hate and divide the county by CIA bots and tolls in Myanmar and Ethiopia and in the Arab Spring regime Change operations in the Middle East and Eastern Europe. Frances Haugen the Face book Whistleblower has revealed how social media is used to game elections etc.

      • 1

        Regardless of the red thumbs, I am glad to note that no abuse is hurled at you for your views on COVID-19.
        Can I take it that people have slightly more open minds now about the prospect of overreaction to what was not quite a killer by itself?

    • 7

      Good Sense

      The armed forces have already turned against innocent unarmed protestors at Gota Go Home Gama. Mahinda sent his goons to stir up and instigate violence, a pattern my Elders have witnessed over the past 70 years.

      Who is going to prevent state and party terrorism?

      • 0

        Native Vedda, (Part I).
        You have addressed me by referring to the incidents that took/or taking place and posing the question “Who is going to prevent state and party terrorism?”. In fact, long before that the question should have been “Who is going to prevent state sponsored Kleptocracy?”. In fact, I thought, like a fool, that perpetrators of economic crimes would be brought to book by the “Yahapalanists”. What happened? They let us down, giving the impression that there is some understanding between the crooks and peoples representatives in power and jeopardized the national security resulting in a 04/21 massacre. In 2019 / 2020 being wiser, I did not fall for it, but many did fall for it and voted the old fellows in new clothing for better handling of affairs of the state. Voila! They messed up (the least to say) to cause this misery jeopardizing the economic and the food security. Can we pack the fellows after giving the “buggers” a blank cheque to rule for 5 years? Both Colvin and JR, perhaps being “Royalists”, did a right Royal trick to the entire population in conferring the sovereignty to the people which in fact is unenforceable legally.

      • 0

        Native Vedda, (Part II).
        Our cry should have been not directed at individuals but a genuine issue. We the people are sovereign but there is no legal mechanism to enforce such sovereignty. In certain states of the USA, a question can be submitted for a referendum if the submission of the question has a given number of signatures. The Governor, elected by the people, was once recalled. Had there been such mechanisms, the uppish behavior of the 2011 to 2015 regime wouldn’t be there, the tragicomedy of the Yahapalana regime would not be there and finally this one would not be there, for the fear of recall. All this time these fellows robbed us, leaving us without fuel, gas, and electricity. To most of us “Go! Go!” is psychologically appeasing but we should have said “bring in the constitutional amendment for us to call for referenda and the right of recall”. I cannot visualize the scenario from now onwards, but my gut feeling is that had our cry been so when the power of the Galle Face “Revolution” was on, which caused the once invincible 2/3rd “Pohottu” majority to smithereens, the request would have been promptly granted.

  • 8

    This young doctor is no means violating the law, but sending a message that the politicians should not be treated like gods.

    I listened to his audio clip added to the media, there he makes it very clear that the patient’s condition is not serious and right at the moment, they should be treated the manner they treat the people. If KAHAKADAYAS ( majority of buddhagama monks) would follow the same, for sure, Mafia boss would not have wasted the people s funds to abuse flights and go to srimahabodhiya today. Why do the PINGUTHTHAYA community get the message yet today is the million dollar question of the hour.

  • 7

    if a politician send STF to attack and kill innocent people; children , women , old aged, and next day go to a doctor for treatment, by jumping the queue and expecting the doctor to see him , solely because of is political power, is it fair for the doctor to tell him no more favours and show him the door.. and politely ask him to come through the proper channels for treatment?


  • 8

    I think there are some people in Sri Lanka .who don’t deserve to be treated ethically.
    Let us ask ourselves this simple question, how many of those that ve have placed our trust on and sent into represent us actually are ethical in the first place.
    Prassana Ranatunga, unlike his brother Arjuna, is a bloody turncoat. He has no ethics, other than the love of oiling the whims and fancy of the murderous, thieving, traitors, by the name of Mara clan.
    They all deserve the harshest of treatment.
    If I were the Doctor in question, I would have given him a kick up his ass to add.

  • 6

    Prof , ethically anyone who shows up to a doctor should be treated. Professional etics are universal and created by our OWN to maintain the highest standards. But people should remember the same standards should be maintained by President, PM , parliamentarians, judiciary, lawyers, security personnel in general every professional. They all should be held accountable and responsible as medical professionals. Here we have the most corrupted anti socials refusing to leave and doctors ethically bound to provide services to them.

    • 5

      As Good Sense mentioned, if reluctant, can always refer to another who is willing to treat. But no one should be outright denied health services.

  • 4

    This ‘Aragalaya’ – ‘අරගලය’ (struggle) should not stop but sustained to gather momentum till the downfall of the corrupt and evil regime.
    I think there is an element of truth in what Prabhakaran said “Sinhalayo have a short memory.
    This learned Professor has forgotten that there was a ‘Aragalaya’ in 2015, although not so visible as the present one to send Rajapakshe regime home using all sorts of fabricated stories. They talked about lamborghinis, golden horses, gold plated toilet seats, gold cutlery and also about money taken out by Rajapakshes. Some guys told they know where that money is hidden.
    6,217,162 retards believed those BS and sent Rajapakshes to Medamulana and brought Ranil and Sirisena hoping that the country will overflow with ‘kiri peni’. Voters believed that ‘Yahapalana’ Government will send corrupt Rajapakshes to Welikada. But they could not find any of the things they claimed and did not punish Rajapakshes for corruption. So, this learned Professor should go and ask Ranil Wickramasinghe why he did not keep his promise instead of singing the same old ‘Baila’ sang in 2015.

  • 3

    “…but sustained to gather momentum till the downfall of the corrupt and evil regime.”

    Like most other ‘Pundits’ who talk about removing this regime, this learned Professor also tell the same thing but does not pay attention to what happens next and what should be done after the regime is gone.
    Has this Professor thought about the cost of this ‘Aragalaya’, particularly island wide ‘Harthal’ to the nation, the sufferings that ordinary folks have to go through because of the ‘Aragalaya’; mainly because of ‘Harthal’ by those in the medical service, public transport and road blocks, and finally who will eventually have to pay for these things.

    I appreciate if the learned Professor watch this video clip:

    • 7

      Blind as Bat!! dumb as a ‘Dodo’!!
      Have you thought of the Dumb “Matti Motta Modaya” who have been warming the seats of the EP, PM. Governor CBSL, Secretary Finance and Finance Minister (FM) and not doing any sensible work act?
      Instead, trialling out on the basis of undiscovered theory of Athana, Hithana, Methana, Natana Prelates’ untested Organics theory (hearsay) and destroying Rural Agriculture (mainly Rice and Vegetable production) and Tea Export Industry, compromising, export earnings and increased import bills for Rice??? EP decided because Athana, Methana threatened of death fast, if not acted upon without delay!! Captive to his Prime Promoters??!!
      Bunch of stupid people from top to bottom???
      What did this government – all powerful – equipped with 20th amendment as the 1st bill to pass in parliament after elections 2020, do to alleviate the Foreign Exchange Crisis for 2.5 years???
      Happily sleeping at the helm and allowing it to providence///!!!
      Then why do you need a government???
      and best of all most powerful intelligentsia to do nothing??!!
      What reason sustain one who let it happen???

  • 2

    The Dilemma ‘To Treat Or Not To Treat’

    The politicians treatment to country calling for go home the minister is complaining of the doctor for treating whole country is blaming the minister to making bankruptcy to front of the world the treatment worse for last 74 years,

    Treatment without prevention is simply unsustainable this is doctor’s way.
    Parliamentarian putting the Country shame front of the world without prevention is worst treatment

  • 7

    In private practice the doctor has the right to pick and choose his patients. Otherwise this useless guy could have gone to govt hospital and joined the queue. These are guys that ruined SL and made the people beggars. These fellows should be allowed to rot leave aside the medical ethics. These goons too have taken oath to serve the country and the people. But really they took oath to plunder the country and used thuggery to oppress the people. This doctor who refused to treat this guy is not only a hero but will go to heaven. All doctors should follow this. If they are sick let them come to govt. hospital.

  • 3

    Dear Prof H De S.
    Well said but one point is debateable.
    …..guilty of not filing cases against those allegations…
    Who does one complain to : Police or AG. And you know these slimy depts. to know the outcome. They will drag inquiries or put the file in a drawer.
    Even if they indict, it will be with loopholes for suspect to escape like Dilrukshi at CIABOC.
    In the current context a Romesh or Ali S will appear and shout at a pliant judiciary to release the suspect.
    All these are not fables but have happened before our eyes.
    So JVP is awaiting for a time when justice can be ensured. They are not guilty, I plead, at this time.

  • 3

    That was a very good piece of advice, without compare!
    question i have is, ‘Could not the doctor in questioned examined the patient (the one whom he detest to treat for good reason or bad) and after initial prognosis, without disclosing an outcome refer him to a senior specialist or parallel medical professional for ultimate outcome and for declaring the results of diagnosis?’

    • 4

      The profession has by and large gone to the dogs.
      There are just a few doctors left who are worthy of the profession these days.
      They are partners in a day light robbery that goes on in this country.
      I have plenty to narrate based on what I have seen in the past 20 years.

  • 12

    Shock! Horror!!
    The thing about this so-called ‘Aragalaya’ is that Rule of Law and all ‘manners’ have been thrown out of the window. The desperados backing this ‘puswedilla’ have approved the ‘anything goes’ approach of the international schools tragics.

    This appalling piece of instructions (by a person who should know better) deserves more condemnation than the original sin of the caddish medibusinessman.
    Didn’t know the writer from a piece of firewood, Having Googled, now I know that he has been a pediatrician (pee-diatrician?), and by the age gap, possibly he has taught the cad Ranil Jayawardena who has brought the already damned medi-businessmen and women of SL to even more disrepute.
    It is shocking that this pee-diatrician has failed to mention the sacred Hippocratic oath once in his sludge.
    In civilised countries, private doctors have the option to refuse treatment only if the patient turns up without appointment, or there are more urgent cases to attend. They certainly don’t have the right to impose their own beliefs onto their patients as a reason not to see them. The case is even worse here because the patient has been treated three times by the rogue businessmen, and the consultation has been sought for side effects of the drugs he prescribed.
    A country without an ethical framework to behave by (politicians and the so-called educated) will be destined to begging.
    Isn’t that what we are seeing?

  • 3

    Stupid Mutt
    I hope you went to support Mara yesterday.
    Of course, you didn’t, you were cowering under the bed like a little bitch.
    At least if you had the courage to watch TV, you would have seen those non-existent Lamborghinis’, Bentleys, and the rest as the boys torched the madamulana stash.
    Bloody idiot eagle, this is what you people should have done back in the 1950s to a bunch of post-colonialist opportunists. Most of you were misled, blinded, and brainwashed to think innocent minorities were your enemy.
    Imagine the irony, what kind of weak majority will be constantly living in fear of the minorities?
    Most of you were systematically programmed to divert your attention, while the post colonial masters continued to trample on and squeeze you people, this is happening to this day, most of you are unable to ascertain the reality on the ground in Sri Lanka, I bet nothing will make the scales off of your eyes. Your brains are too thick.
    One thing you can count on is Karma. You are beginning to see the wheels of Karma in motion. This month of May means something, especially to Mara and Co, it will soon make proper sense.

  • 2

    Guys, the above comment was in response to EE’s comments above.
    I wonder how it ended up at the bottom.
    Please understand that Stupid Mutt was referring to EE.
    Take note when you read.

  • 1

    one thing has to be stated clearly.This doctors behaviour is not ethical. Besides on his own admission he has seen this patient twice before. This is this doctors imature knee jerk reaction after attending “Direction Sri Lanka” meeting or a publicity stunt or both.

  • 1

    going in a round about way will not help here. There is a SLMC booklet on medical ethics and professional conduct.

    • 0

      Where is it hidden?

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